TY - JOUR
T1 - Norfloxacin for prevention of bacterial infections in granulocytopenic patients
AU - Winston, Drew J.
AU - Ho, Winston G.
AU - Champlin, Richard E.
AU - Karp, Judith
AU - Bartlett, John
AU - Finley, Rebecca S.
AU - Joshi, Jai H.
AU - Talbot, George
AU - Levitt, Lee
AU - Deresinski, Stan
AU - Corrado, Michael
N1 - Funding Information:
From the Division of Hematology-Oncology, Department of Medicine, UCLA Center for the Health Sciences, Los Angeles, California; the Divisions of Hematology-Oncology and Infectious Diseases, Department of Medicine, Johns Hopkins Medical Center, Baltimore, Maryland; the Division of Infectious Diseases, Department of Medicine, University of Pennsylvania Medical Center, Philadelphia, Pennsylvania; the Division of Infectious Diseases, University Maryland Cancer Center, Baltimore, Maryland; Divisions of Infectious Diseases and Hematology, Department of Medicine, Stanford Medical Center, Stanford, California; and Merck Sharp and Dohme Research Laboratories, West Point, Pennsylvania. This work was supported by a grant (CA-23175) from the National Cancer Institute and research grants from Merck Sharp and Dohme Research Laboratories, Rahway, New Jersey. Requests for reprints should be addressed to Dr. Drew J. Winston, Room 42-121, Department of Medicine, UCLA Center for the Health Sciences, Los Angeles, California 90024.
PY - 1987/6/26
Y1 - 1987/6/26
N2 - The efficacy and safety of norfloxacin were compared with those of placebo, vancomycin-polymyxin, and trimethoprim-sulfamethoxazole (TMP/SMX) for prophylaxis of bacterial infections in granulocytopenic patients. The study results showed that norfloxacin treatment, which was well tolerated and not associated with any serious systemic adverse effects, prevented acquisition of gram-negative bacillary organisms. Fewer norfloxacin-treated patients (38 of 108 patients, or 35 percent) experienced microbiologically documented infections compared with patients receiving placebo (27 of 40 patients, or 68 percent), vancomycin-polymyxin (16 of 30 patients, or 53 percent), or TMP/SMX (14 of 28 patients, or 50 percent). Gram-negative bacteremia developed in five of 108 norfloxacin-treated patients (5 percent), compared with 17 of 40 placebo-treated patients (43 percent), five of 30 treated with vancomycin-polymyxin (17 percent), and one of 28 patients treated with TMP/SMX (4 percent). The incidence of gram-positive bacteremia was similar in all study groups and was not affected by norfloxacin or any other oral prophylactic antibiotics. These results suggest that norfloxacin is both safe and effective for the prevention of serious gram-negative bacillary infections in granulocytopenic patients. More effective prophylaxis of gram-positive bacterial infections, however, is needed.
AB - The efficacy and safety of norfloxacin were compared with those of placebo, vancomycin-polymyxin, and trimethoprim-sulfamethoxazole (TMP/SMX) for prophylaxis of bacterial infections in granulocytopenic patients. The study results showed that norfloxacin treatment, which was well tolerated and not associated with any serious systemic adverse effects, prevented acquisition of gram-negative bacillary organisms. Fewer norfloxacin-treated patients (38 of 108 patients, or 35 percent) experienced microbiologically documented infections compared with patients receiving placebo (27 of 40 patients, or 68 percent), vancomycin-polymyxin (16 of 30 patients, or 53 percent), or TMP/SMX (14 of 28 patients, or 50 percent). Gram-negative bacteremia developed in five of 108 norfloxacin-treated patients (5 percent), compared with 17 of 40 placebo-treated patients (43 percent), five of 30 treated with vancomycin-polymyxin (17 percent), and one of 28 patients treated with TMP/SMX (4 percent). The incidence of gram-positive bacteremia was similar in all study groups and was not affected by norfloxacin or any other oral prophylactic antibiotics. These results suggest that norfloxacin is both safe and effective for the prevention of serious gram-negative bacillary infections in granulocytopenic patients. More effective prophylaxis of gram-positive bacterial infections, however, is needed.
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U2 - 10.1016/0002-9343(87)90617-6
DO - 10.1016/0002-9343(87)90617-6
M3 - Article
C2 - 3037899
AN - SCOPUS:0023633996
SN - 0002-9343
VL - 82
SP - 40
EP - 46
JO - The American journal of medicine
JF - The American journal of medicine
IS - 6 SUPPL. 2
ER -